Risk of Comorbidities on Postoperative Outcomes in Patients With Inflammatory Bowel Disease
Risk of Comorbidities on Postoperative Outcomes in Patients With Inflammatory Bowel Disease
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DOI：
10.1001/archsurg.2011.194
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发表时间：
2011-08-01
影响因子：
--
通讯作者：
Myers, Robert P.
中科院分区：
文献类型：
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作者：
Kaplan, Gilaad G.;Hubbard, James;Myers, Robert P.
背景：合并症对炎症性肠病（IBD）患者术后结局的影响尚未得到充分研究。我们评估了并发症的患病率和他们对术后结果的影响后，IBD相关operation.Methods：全国住院患者样本数据库被用来确定35 588例IBD谁经历了IBD相关的操作从1995年1月1日，通过2005年12月31日。使用Elixhauser指数评估合并症的存在。在校正年龄、性别、种族、健康保险状况和入院类型后，进行多因素logistic回归分析，以评估合并症对死亡率的影响。结果：术后死亡率为1.9%。随着合并症数量的增加（即，0、1、2或≥ 3），术后死亡率增加（分别为0.4%、1.5%、3.3%和7.9%）。充血性心力衰竭（比值比，3.50 [95%置信区间，2.63-4.62]）、肝脏疾病（3.15 [2.00-4.97]）、血栓栓塞性疾病（4.19 [3.37-5.21]）和肾脏疾病（8.74 [5.44-14.05]）与死亡率显着增加相关。与死亡风险增加相关的合并症也与住院时间和住院费用显著增加相关。结论：合并症werecomon IBD患者，他们显着增加IBD患者术后死亡率和医疗保健使用的风险。
Background: The effect of comorbidities on postoperative outcomes in patients with inflammatory bowel disease (IBD) has not been explored adequately. We evaluated the prevalence of comorbidities and their effect on postoperative outcomes after an IBD-related operation.Methods: The Nationwide Inpatient Sample database was used to identify 35 588 patients with IBD who underwent an IBD-related operation from January 1, 1995, through December 31, 2005. The presence of comorbid illness was assessed using the Elixhauser index. Multiple logistic regression analysis was performed to evaluate the effect of comorbidities on mortality rate after adjusting for age, sex, race, health insurance status, and admission type. Linear regression models were used to evaluate health care resource use.Results: Postoperative mortality was 1.9%. As the number of comorbidities increased (ie, 0, 1, 2, or >= 3), postoperative mortality increased (0.4%, 1.5%, 3.3%, and 7.9%, respectively). Congestive heart failure (odds ratio, 3.50 [95% confidence interval, 2.63-4.62]), liver disease (3.15 [2.00-4.97]), thromboembolic disease (4.19 [3.37-5.21]), and renal disease (8.74 [5.44-14.05]) were associated with a significant increase in mortality rate. Comorbidities associated with an increased risk of mortality also were associated with a significant increase in length of stay and hospital charges.Conclusions: Comorbidities werecommonin patients with IBD and they significantly increased the risk of postoperative mortality and health care use in patients with IBD.